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Health Centers' Preparedness for Coronavirus (COVID-19) Pandemic in South Wollo Zone, Ethiopia, 2020

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Health Centers' Preparedness for Coronavirus (COVID-19) Pandemic in South Wollo Zone, Ethiopia, 2020 Risk Management and Healthcare Policy Dovepress open access to scientific and medical research Open Access Full Text Article ORIGINAL RESEARCH Health Centers’ Preparedness for Coronavirus (COVID-19) Pandemic in South Wollo Zone, Ethiopia, 2020 This article was published in the following Dove Press journal: Risk Management and Healthcare Policy Fanos Yeshanew Ayele Background: COVID-19 is a highly contagious respiratory disease caused by severe acute Aregash Abebayehu Zerga respiratory syndrome coronavirus two (SARS-CoV-2). Preparedness of health facilities to prevent Fentaw Tadese the spread of COVID-19 is an immediate priority to safeguard patients and healthcare workers and to reduce the spread of the pandemic. However, the preparedness of health centers in south Wollo School of Public Health, College of Medicine and Health Sciences, Wollo zone is unknown. University, Dessie, Ethiopia Objective: To assess the preparedness of Health Centers for COVID-19 in South Wollo Zone, Ethiopia, 2020. Methods: Health facility-based cross-sectional study was conducted among forty-six Health Centers in South Wollo zone in August 2020. The sampled health centers were selected by lottery method. The data was collected from the manager of the health centers using a pretested interviewer-administered and observational checklist. The ReadyScore criteria was used to classify the level of preparedness, in which health centers with a score of >80%, 40–80%, and <40% were considered as better prepared, work to do, and not ready, respectively. Results: In this study, the median score of health centers preparedness for COVID-19 was 70.3 ± 21.6 interquartile ranges with a minimum score of 40.5 and the maximum score of 83.8. Only 12 (26.1%) of the health centers were prepared for the COVID-19 pandemic. The majority (73.9%) of the health centers were found within the group of “work to do”. Conversely, none of the health centers were found within the “not ready” or below group. Conclusion: This study concluded that the preparedness status of the majority of health centers in South Wollo Zone was within the “work to do” group. Therefore, the local government and other concerned bodies should monitor and support health centers to increase their preparedness and to build their capacity. Keywords: COVID-19, preparedness, health centers, South Wollo Zone, Ethiopia Introduction Coronavirus Disease 2019 (COVID-19) is a highly transmittable respiratory disease caused by severe acute respiratory syndrome coronavirus two (SARS-CoV-2). It is transmitted mostly by contact with infectious material that is projected during sneezing or coughing of infected patients.1 It has the most common symptoms of fever, dry cough, shortness of breath, and tiredness, and less common symptoms of loss in taste and smell, sore throat, headache, diarrhea, aches, pains, and may Correspondence: Aregash Abebayehu progress to pneumonia and respiratory failure.2 It was first reported from Wuhan Zerga 3 Email [email protected] City, China in December 2019 and now spread at alarming rates all over the world. submit your manuscript | www.dovepress.com Risk Management and Healthcare Policy 2021:14 887–893 887 DovePress © 2021 Ayele et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php http://doi.org/10.2147/RMHP.S290135 and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Ayele et al Dovepress Until October 31, 2020, over 46 million confirmed cases recognized as critical to shift the pandemic. However, after and 1.19 million deaths were reported in the world.4 In the onset of the COVID-19, quantitative data on the pre­ Africa, since February 14, 2020, when the first case was paredness of health facilities for covid-19 is limited. Even reported, above 1.8 million cases, and 42,630 deaths were though a study was conducted on health systems adapt­ recorded.5 In Ethiopia from March 13, when the case was ability in Ethiopia, it was not published in a peer-reviewed first detected, until October 31, 2020, a total of 95,789 journal and was conducted by including only 9.8% of the cases and 1, 464 deaths, were reported.6 national health centers.16 Hence, assessing healthcare Due to its infection and rapid transmission, the World facilities’ preparedness is a high priority.17 Therefore, Health Organization (WHO) was declared a Public Health this study aimed to assess health centers preparedness Emergency of International Concern and characterized it towards COVID-19 pandemic which helps to prioritize 7 as a pandemic. In Ethiopia to mitigate the COVID-19 supports to health centers with significant gaps in pandemic, the laboratory test, and treatment centers were preparedness. extended to regions, zones, and district levels. Physical distancing, hand hygiene, and mask-wearing were highly promoted through media by using drama, music, and pos­ Methods ters. For physical distancing to be maximally implemen­ Study Design and Setting ted, schools of all levels were closed; religious gatherings Health facility-based cross-sectional study design was car­ were limited and transport across cities was banned. ried out in August 2020. The study was conducted among The prevention measures include heightened surveil­ the Health centers of South Wollo zone, Amhara Region, lance and rapid identification of suspected cases, followed Ethiopia. It is one of the 11 Zones of the Amhara regional by patient transfer and isolation, rapid diagnosis, tracing, state of Ethiopia. It is bordered on the south by North and follow-up of potential contacts.8 The ability to control Shewa, on the west by East Gojjam, on the northwest by local transmission depends on the application of principles South Gondar, on the north by North Wollo, on the north­ of rapid identification, prevention, and control, followed east by Afar Region, and on the east by the Oromia special by patient isolation, rapid diagnosis, and contact tracing.9 Zone and Argobba special district. Towns and cities in the The WHO has already developed a global COVID-19 south Wollo zone include Dessie, Kombolcha, Haik, strategic preparedness and response plan, which aims to Wuchale, Akesta, and Mekaneselam and it has 22 districts. support countries to accelerate the development of their The capital city of south Wollo zone is Dessie town which capacity to prevent, detect, and respond to any potential is located 401 km north of Addis Ababa the capital of COVID-19 outbreak.10 Ethiopia developed the national Ethiopia. According to zonal health Department data, comprehensive COVID-19 management handbook interim a total of 135 health centers are found in the zone. guideline for healthcare settings, healthcare facility COVID-19 preparedness and response protocol and the Sample Size and Sampling Technique ministry of health essential care services guideline during In south Wollo zone, there are 135 health centers. From COVID-19.11,12 these, 46 (34%) health centers were selected by lottery The preparedness level of countries or organizations to method for this study. prevent an emergency was classified using the ReadyScore criteria created by the “resolve to save lives”.13 The score determines whether a country is prepared to find, stop, and Data Collection and Control prevent epidemics, using data from the WHO’s Joint The data was collected from the manager of health centers. External Evaluation (JEE).14 Based on this criteria, coun­ A pre-tested interviewer-administered checklist and obser­ tries are classified into five levels; better prepared (over vation checklist adapted from the WHO and Centers for 80%), work to do (40–80%), not ready (under 40%), in Disease Control (CDC) was used to collect the data progress, and unknown.13 Before the onset of COVID-19, (Appendix 1).18,19 Before the actual data collection, the the preparedness of Ethiopia for an emergency was checklist was pretested on 5% (2 health centers) of the 52%.14,15 This means there is a potential for lives to be sample size at Oromia special zone, Amhara region. The lost if a new health threat emerges in the country. The data was collected using the local language, Amharic by preparedness of health facilities for COVID-19 response is two trained public health officers. The completeness of the 888 submit your manuscript | www.dovepress.com Risk Management and Healthcare Policy 2021:14 DovePress Dovepress Ayele et al collected data was checked by the supervisor and the Result principal investigators. Description and Preparedness of the Health Centers Operational Definition About one third (34.8%) of the health centers were from Preparedness the urban area. The median score of preparedness for A total of 37 (yes or no) questions were used to compute COVID-19 was 70.3 ±21.6 interquartile ranges, with the preparedness. Responses to these questions were a minimum and maximum score of 40.5 and 83.8, respec­ summed and converted into percent. Then, based on the tively. When categorized by the ReadyScore cut-offs, only ReadyScore criteria of preparedness; health centers were 12 (26.1%) of the health centers were prepared for the classified as “better prepared” if they scored over 80%, pandemic (scored over 80%). Majority (73.9%) of the “work to do” if scored 40 to 80%, and “not ready” if health centers were found within the group of “work to 13 scored less than 40%. do”. Conversely, none of the health centers was found within the “not ready” or below group.
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